Nokea
A nurse works with several clients who have gout. Which types of gout and their drug treatments are correctly matched? (Select all that apply.)
- A. Allopurinol (Zyloprim): Acute gout
- B. Colchicine (Colcrys): Acute gout
- C. Febuxostat (Uloric): Chronic gout
- D. Probenecid: Chronic gout
- E. Indomethacin: Acute gout
Correct Answer: B,C,D,E
Rationale: Colchicine and indomethacin are used for acute gout attacks. Febuxostat and probenecid are used for chronic gout management. Allopurinol is also used for chronic gout, not acute gout.
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A nurse is caring for a client with systemic sclerosis. The client's facial skin is very tight, limiting the ability to open the mouth. Besides a consultation with a registered dietitian for appropriate nutrition, what other consultation should the nurse facilitate?
- A. Dentist
- B. Massage therapist
- C. Occupational therapy
- D. Physical therapy
Correct Answer: A
Rationale: With limited ability to open the mouth, dental hygiene may be lacking. The nurse should encourage the client to see a dentist. The other referrals are not related to the mouth.
Which clinical manifestations are seen in clients with connective tissue diseases? (Select all that apply.)
- A. Dry, scaly skin rash: Systemic lupus erythematosus
- B. Esophageal motility problems: Systemic sclerosis
- C. Vasculitis leading to organ damage: Rheumatoid arthritis
- D. Foot drop and paresthesias: Rheumatoid arthritis
- E. Gout caused by hyperuricemia
Correct Answer: A,B,C,D,E
Rationale: A dry, scaly skin rash is common in SLE. Systemic sclerosis can lead to esophageal motility problems. Vasculitis leads to organ damage in rheumatoid arthritis. Foot drop and paresthesias occur in rheumatoid arthritis. Gout is caused by hyperuricemia.
After a total knee replacement, a client is on the postoperative nursing unit with a continuous femoral nerve block. On assessment, the nurse notes the client's pulses are 2+/4 bilaterally, the skin is pale pink, warm, and dry, and the client is unable to dorsiflex or plantarflex the affected foot. What action does the nurse take?
- A. Document the findings and monitor as prescribed
- B. Increase the frequency of monitoring the client
- C. Notify the surgeon or anesthesia provider immediately
- D. Palpate the client's bladder to perform a bladder scan
Correct Answer: C
Rationale: With the femoral nerve block, the client should still be able to dorsiflex and plantarflex the affected foot. Since this client has an abnormal finding, the nurse should notify either the surgeon or the anesthesia provider immediately. Documentation is the last priority. Increasing the frequency of assessment may be a good idea, but first the nurse must notify the appropriate person. Palpating the bladder is not related.
A client with rheumatoid arthritis (RA) is on the postoperative nursing unit after having elective surgery. The client reports that the arm feels like pins and needles and that the neck is painful since returning from surgery. What action by the nurse is best?
- A. Assist the client to change positions
- B. Encourage range of motion of the neck
- C. Notify the provider immediately
- D. Provide pain medication as ordered
Correct Answer: C
Rationale: Clients with RA can have cervical joint involvement. This can lead to an emergent situation due to potential spinal cord compression. The nurse should notify the provider immediately to assess for this serious complication.
The nurse is teaching a client with gout dietary strategies to prevent exacerbations or other problems. Which statement by the nurse is most appropriate?
- A. Drink 1 to 2 liters of water daily
- B. Have 10 to 12 ounces of juice daily
- C. Liver is a good source of iron
- D. Avoid alcohol consumption
Correct Answer: A
Rationale: Kidney stones are common in clients with gout, so drinking plenty of water will help prevent this from occurring. Citrus juice is high in acid, which can help prevent the formation of stones, but the value of this recommendation is not clear. Clients with gout should not consume organ meats or fish with bones, such as sardines.